Echocardiography during cardiac arrest

Text Genevieve Carbonatto The management of cardiac arrest has been intensively studied over the past 20 year and other than early and good quality CPR and early defibrillation in VF, very little has shown to improve the prognosis in cardiac arrest. The last 20 years has shown that high dose adrenaline, vasopressin, supplementary oxygen, treatment Read more about Echocardiography during cardiac arrest[…]

Coarctation of the aorta in a neonate

Images Chris Harrington, text Genevieve Carbonatto A 11 day old presents to the Emergency department in acute respiratory distress. His mother states that his SOB has increased markedly over the past 24 hours.  While on the way to hospital he has an episode of tachypnea  cyanosis and not breathing for 5 seconds. He has been Read more about Coarctation of the aorta in a neonate[…]

Bacterial endocarditis : Mitral valve

Images Nick Stewart, text  Genevieve Carbonatto A 50 year old man presents to the ED with a 6 week history of general malaise, fevers, night sweats and weight loss (10 kg). He had been prescribed 7 courses of Augmentin by his GP and felt generally better on this antibiotic. An outpatient CT showed some nodes Read more about Bacterial endocarditis : Mitral valve[…]

Eyeballing LV function : Test yourself

Gollum, Wellington Airport, Weta Studios Estimating ejection fraction (EF) can be done by eyeballing LV contraction on ECHO. This requires some skill and expertise. A very basic assessment in the Emergency department requires a parasternal long axis (PLAX), a parasternal short axis (PSAX) and a 4 chamber view (4CV). What are we looking for ? Read more about Eyeballing LV function : Test yourself[…]

Right ventricular thrombus

Images and  text Genevieve Carbonatto A 35 year old man presents to the Emergency Department with severe shortness of breath. He is known to have an amphetamine induced cardiomyopathy. His heart rate is 129/min, BP 116/76. He has mild pedal oedema. His JVP is elevated and on auscultation he has crepitations bilaterally. You decide to Read more about Right ventricular thrombus[…]

Assessment of Pericardial effusion

Text and images Genevieve Carbonatto Pericardial effusions are commonplace. A pericardial effusion is not synonomous with pericardial tamponade. Pericardial tamponade is a medical emergency characterised by shock and associated with a number of clinical criteria including Becks triad (hypotension, decreased heart sounds, elevated JVP) pulsus paradoxus ( > 12 mmHg drop in BP on inspiration), Read more about Assessment of Pericardial effusion[…]

Takotsubo cardiomyopathy

Images and text Genevieve Carbonatto A 52 year old lady presents to the Emergency Department with chest pain. After an argument with her husband about his spending she developed acute severe central chest pain radiating down her right arm. She is mildly SOB. There is no past history of note, notably no cardiovascular risk factors. Read more about Takotsubo cardiomyopathy[…]